Kornimate/medical-research-clean huggingface dataset:
comparison of the effects of aerobic exercise training and mat pilates exercise on blood pressure, functional capacity and quality of life in hypertensive individuals

Conditions: Hypertension

Summary: the research aims to compare two different exercise approaches applied to hypertensive individuals. after completion of the research, it will be revealed which exercise approach is more effective on the parameters evaluated in hypertensive individuals. in this context, it is aimed to increase the use of the exercise approach, which is found to be more effective in hypertensive individuals, in the treatment program.

exercise is an important lifestyle change in treating and controlling hypertension. the international society of hypertension recommends increasing physical activity in the long term as a lifestyle intervention to improve blood pressure control and reduce the risk of cardiovascular disease in hypertensive individuals. regular exercise appears to reduce drug use as part of lifestyle change in the treatment of hypertension. the risk of developing hypertension in individuals with a sedentary lifestyle is higher than in individuals who engage in regular physical activity. in addition, new exercise programs such as mat pilates exercises are also applied to hypertensive individuals. mat pilates exercises are a resistance exercise method used worldwide, especially for middle-aged individuals who do not engage in regular physical activity. in addition, mat pilates exercises have promising effects, reducing short-term systolic blood pressure by 7.4 mmhg and long-term resting systolic blood pressure by 5.8-7.6 mmhg and diastolic blood pressure by 3.3-3.6 mmhg. these data require further research on the use of mat pilates exercises in hypertensive individuals. the research aims to compare two different exercise approaches applied to hypertensive individuals. after completion of the research, it will be revealed which exercise approach is more effective on the parameters evaluated in hypertensive individuals. in this context, it is aimed to increase the use of the exercise approach, which is found to be more effective in hypertensive individuals, in the treatment program.

Eligibility criteria:
inclusion criteria: * hypertension (blood pressure ≥ individuals diagnosed with 85/135 mmhg) and under medical follow-up, * volunteering to participate in the study, * not having been included in any exercise program in the last 4 weeks. exclusion criteria: * blood pressure individuals with ≥ 110/180 mmhg, * having had a cerebrovascular accident or cardiovascular disease in the last 6 months, * having an orthopedic or neurological disorder that prevents walking. * having serious cardiovascular/pulmonary disease.

Keywords: hypertensive disease aerobic exercise mat pilates exercise hypertension blood pressure functional capacity quality of life (qol) physiotherapy and rehabilitation
validity of brain metastasis risk predictive model in hormone positive breast cancer patients

Conditions: Breast Cancer, Estrogen Receptor-Positive

Summary: this study aims to validate a prediction model of brain metastasis risk for females with hr+ breast cancer by using variables collected at diagnosis.

1. data collection: age at bc diagnosis, tumor size, axillary adenopathy, clinical stage, her2 status, ki67 proliferation index and the modified scarff-bloom-richardson grade of differentiation. 2. analysis plan: continuous variables as means and standard deviation (sd) if they follow a normal distribution; if not, as medians and iqr (interquartile range). numbers and percentages display categorical variables. 3. model validation: the association between covariates and the diagnosis of brain metastases by performing logistic regression analyses; odds ratio (or), 95 % confidence intervals (ci), and p-value will be estimated. variables with a p-value \< 0.05 in the univariate logistic regression analysis will be further assessed in a multivariate logistic regression analysis. for the clinical use of the model, we will use a score to each variable as that designed by cacho-díaz b. et. al. then, we will categorize patients into three risk groups according to the sum of the scores. we will employe a cox regression analysis to assess each group's risk of developing brain metastases. adjusted hazard ratios (ahrs), 95 % cis, and p values will be evaluated.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of hr-positive primary invasive breast cancer. exclusion criteria: 1. patients if they were diagnosed with brain metastases at the time of initial breast cancer diagnosis or within the subsequent three months. 2. bilateral breast cancer. 3. synchronic cancer (i.e., lung cancer, melanoma). 4. paitents presenting neurologic symptoms without follow-up or lacking a contrast-enhanced magnetic resonance image (cmri). 5. incomplete clinicopathological information at the time of diagnosis.

Keywords: breast cancer hormonal receptor positive brain metastasis risk prediction model
superficial cervical plexus blockade for clavicle fracture analgesia

Conditions: Pain, Postoperative; Satisfaction

Summary: the goal of the study is to determine if the addition of a superficial cervical plexus block to a traditional interscalene plexus block will provide superior perioperative analgesia to an interscalene brachial plexus blockade alone for repair of clavicle fractures and non-/malunions.

when patients that are possible participants in the study present for surgery, they will be offered the opportunity to participate in the trial as part of the informed consent process. should they agree to participate, they will be randomized to receive either an interscalene + "sham" superficial cervical plexus block or an interscalene + superficial cervical plexus block. the randomization will have already been predetermined based off of envelopes that will have been created by a research assistant. within the envelopes the proper paperwork needed to consent a participant along with a label that will be labeled either interscalene + sham superficial cervical plexus block or interscalene + superficial cervical plexus block. this will assign the randomization of each participant (this will be unknown to all study personnel until identified by the label). their pain scores will be assessed pre-operatively as well as post-operatively .. if they are admitted to the hospital, the pi and/or co-investigators will assess their pain scores on a daily basis and follow-up with a phone call to assess their satisfaction with the block. numerical pain scores (scale of 0-10) will be used to assess post-operative pain with 0 indicating no pain and 10 indicating severe pain. post-operative pain will be assessed by compiling pain scores from 2 different sources: numerical pain scores recorded by nursing staff (vitals section of emr) and also pain scores ascertained by residents during rounds (progress notes). for each pain score, we will record the date and time it was obtained. if they are discharged the same day as surgery, they will receive a phone call within 48 hours to assess their pain scale and satisfaction. we will also assess nausea and vomiting, the amount and type of pain medicine they are taking, and assess if they could tell when their block wore off.

Eligibility criteria:
inclusion criteria: * patients who present for repair of isolated clavicle fractures and non-/malunions that consent to regional anesthesia and to be a part of the study. exclusion criteria: * polytraumatized patients with multiple confounding injuries, patients who are not candidates for either block at the discretion of the anesthesia attending, patient refusal to participate in study, patient refusal of regional technique, patients with significant pulmonary disease that will not tolerate possible hemi-diaphragmatic paralysis at the discretion of the attending anesthesiologist.

Keywords: cervical plexus block clavicle fracture interscalene brachial plexus block
prevention of ventilator-associated pneumonia by automatic control of the tracheal tube cuff pressure

Conditions: Ventilator-Associated Pneumonia; Mechanical Ventilation

Summary: background: the aspiration of contaminated secretions pooled above the endotracheal tube cuff secondary to inadvertent falls of cuff pressure is the main pathogenic mechanism of ventilator-associated pneumonia (vap). aim of the study: to assess the efficacy of an automatic device for the continuous regulation of tracheal tube cuff pressure in decreasing the incidence of vap.

design: prospective, randomized, controlled trial, with 2 groups: study (automated control of cuff pressure) and control (standard control of cuff pressure). setting: respiratory intensive care unit (ricu). subjects: patients \>18 yr, intubated and ventilated. interventions and measurements: study group (cuff pressure will be kept constant at 25 cmh2o with the automatic device) and control group (cuff pressure control every 8 h. at the same level using a manual pressure controller, according with standard routine); recording of clinical variables at admission and during ricu stay, and end-point variables (incidence of vap, etiologic microorganisms, ricu and hospital stay, ricu and 60-d mortality. expected results: lower incidence of vap in study group, compared with control group.

Eligibility criteria:
inclusion criteria: * patients older than 18 years, * orotracheal intubation for less than 24 hours * expectancy to remain on mechanical ventilation for more than 48 hours exclusion criteria: * pneumonia * witnessed macroscopic aspiration

Keywords: ventilator-associated pneumonia mechanical ventilation tracheal tube cuff pressure
title endovascular treatment of superior cave syndromes reaching the trifurcation: a single-center case series

Conditions: Superior Cave Syndrome

Summary: superior vena cava syndrome (scs) is caused by obstruction of blood flow in the superior vena cava, which allows venous return from the upper half of the body to the heart. the causes are most often oncological, but can also be benign (coagulopathy, behçet) or iatrogenic (catheterisation, pac). the surgical management of superior vena cava syndromes (scs) involves the use of innovative endovascular techniques, which have become the therapy of first choice for symptomatic patients, whether the occlusion occurs in a benign or malignant context. for occlusive lesions involving the trifurcation, there are several surgical approaches and strategies, but very little data on their efficacy. in particular, y-stenting has been described in several case reports as a means of treating the scs and keeping the two jugulo-subclavian veins (vjsc) patent. this innovative technique has been used for several years by the vascular surgery team at hôpital louis pradel. the aim of our study is to assess the feasibility and medium-term efficacy of innovative endovascular treatments for scs involving the trifurcation.


Eligibility criteria:
inclusion criteria: * all patients treated by endovascular surgery (stenting) at hospices civils de lyon between march 2019 and july 2023 for superior cave syndrome exclusion criteria: * minor patients * patients unable to give consent * patients unable to understand french * patients with lesions not reaching the trifurcation (elective involvement of the superior vena cava)
assessment of transcatheter edge-to-edge repair in atrial functional mitral regurgitation (atrial-mr)

Conditions: Atrial Functional Mitral Regurgitation; Mitral Insufficiency

Summary: this investigator-initiated, multicenter, international, retrospective registry aims to investigate outcomes of patients with atrial functional mitral regurgitation, as treated in clinical routine.


Eligibility criteria:
inclusion criteria: * functional mitral regurgitation * left ventricular ejection fraction ≥50% exclusion criteria: * age under 18 years * known regional wall movement disorders

Keywords: atrial functional mitral regurgitation afmr atrial secondary mitral regurgitation asmr mitral valve transcatheter edge-to-edge repair m-teer
lowering peep: weaning from high peep setting

Conditions: Mechanical Ventilation Complication

Summary: the perfusion of the deeply different areas coexisting in ards lung generates two type of venus-admixure : true shunt and shunt effect. briefly, true shunt and shunt effect are related to non-aerated and poorly-ventilated lung areas perfusion respectively. practically, it is not possible to quantify the true shunt and the shunt-effect directly, but we can measure the "total-shunt", i.e. the sum of two kind of venus-admixured. as it is known from classical physiology, the effects of fio2 variations on pao2 are deeply different depending on the type of venous admixures. in the case of a patient with virtually only true shunt, any fio2 variation will not modify the pao2. on the other hand, in a patient with virtually only a shunt effect, increasing the fio2 the pao2 will progressively increase. indeed, ventilating a patient presenting only a shunt effect (without true shunt) with pure oxygen will generate a "normal" p/f ratio. in patients ventilated with high peep levels it is difficult to predict based on the p/f ratio the relative amount of true shunt and shunt effect. however, patients presenting a significant shunt effect when ventilated with higher peep level would likely have "unstable" poorly aerated lung areas that need peep to remain opened. in those patients, a peep-weaning protocol based on the p/f ratio could induce significant alveolar de-recruitment and clinical deterioration. on the contrary, patients with less shunt effect would be likely less prone to alveolar de-recruitment and would benefice from peep decrease.

the investigators set up a study to test the hypothesis that patients presenting a significant shunt effect when ventilated with higher peep levels could be prone to significant alveolar de-recruitment at the peep weaning attempt. to do so, the investigator has to measure the total shunt at higher peep level in patients ready to be weaned from the peep (according to the mercat protocol), at three fio2 levels (i.e. 0,3, 0,6 and 1). the shunt effect is quantified as the difference in total shunt between fio2 0,3 and .the hypothesis of this study is that the shunt effect could predict alveolar de-recruitment when weaning peep.

Eligibility criteria:
inclusion criteria: * age major than 18 * 1-2 days since the beginning of mechanical ventilation * moderate or severe ards exclusion criteria: * patients with a story of chronic obstructive pulmonary disease (copd) * patients with asthma * patients with neurological disease * patients with heart disease * patients with cardiopulmonary.
effect of local anesthesia on postoperative pain following sacrospinous ligament fixation

Conditions: Pelvic Organ Prolapse

Summary: during surgery for pelvic organ prolapse, it is common for the surgeon to inject fluid into the vaginal tissues to help with tissue dissection. it is common that anesthetic medication is mixed into this fluid to help with pain control after surgery. usually the pain medication injected is short-acting. in this study the investigators plan to compare the usual short-acting injected pain medication with a long-acting injected pain medication to evaluate whether this improves pain control after surgery. one type surgical procedure for prolapse will be evaluated. the procedure is sacrospinous ligament fixation. this is suspension of the vagina to treat pelvic organ prolapse. study participants will be randomized to one of two study groups: 1. lidocaine group (short-acting medication). 2. liposomal bupivacaine group (long-acting medication) information will be collected on study participants, including: demographics, procedure data, and post-operative information. the primary outcome of this study is determine if use of long-acting injected local anesthesia at the time of sacrospinous ligament fixation leads to less post-operative pain compared to short-acting local anesthesia. secondary outcomes include: 1. post-operative opioid medication use 2. return to baseline pain status 3. post-operative time to first bowel movement 4. post-operative antiemetic use (nausea medication) 5. results of voiding trial after surgery 6. patient satisfaction with pain control


Eligibility criteria:
inclusion criteria: 1. female gender 2. age ≥ 18 years, ≤95 years 3. planned vaginal sacrospinous ligament fixation with anterior and/or posterior colporrhaphy (sslf apc) to treat pelvic organ prolapse with or without retropubic mid urethral sling 4. able to give informed consent to participate exclusion criteria: 1. male 2. age \ 95 years 3. unable or unwilling to give informed consent to participate 4. pregnancy 5. history of chronic pelvic pain, narcotic abuse, or daily narcotic usage in the last six months 6. known allergy / intolerance to either lidocaine, bupivacaine liposomal, ketorolac, motrin, or acetaminophen 7. known renal or hepatic insufficiency 8. planned hysterectomy at the time of prolapse repair 9. planned transobturator mid urethral sling at the time of prolapse repair
novel technique in closure of mesenteric defects after laparoscopic roux-en-y gastric bypass and its effect on internal hernia: a case-control study

Conditions: Bariatric Surgery

Summary: this study is to investigate the rate of internal hernia after laparoscopic rox-en-y gastric bypass when the defects are closed using cyano-acrylate glue.

background internal hernia complicated by bowel obstruction is a well-recognized complication of laparoscopic roux-en-y gastric bypass (lrygb). the present study aims to investigate the role of cyanoacrylate glue in the prevention of internal hernia (ih) after lrygb and compare it with the open technique of managing mesenteric defects by leaving the mesentery intact without closure of mesenteric defects. data from six uk hospitals have been involved in this study. operations were done under the supervision of a single senior consultant surgeon of bariatric surgery. methods the prospectively collected data of 813 patients with morbid obesity who underwent lrygb were retrospectively analyzed. patients were subdivided into two groups: group i comprising 185 patients who had the mesenteric defects closed with cyanoacrylate glue and group ii comprising 628 patients who were managed by the open technique of leaving the mesentery intact without closure of the mesenteric defects.

Eligibility criteria:
inclusion criteria: * all patients who underwent antecolic lrygb without closure of mesenteric defects using cyanoacrylate glue or without closure of the mesenteric defects. exclusion criteria: * open rygb, laparoscopic converted to open rygb, laparoscopic retro-colic rygb, laparoscopic ante-colic rygb with closure of the defect using sutures or rygb done for non-bariatric purposes e.g. idiopathic gastroparesis.

Keywords: bypass, gastric; obesity, morbid; glue. internal hernia; laparoscopy.
efficacy and safety of tms and deep tms treatment for psychiatric and neurological disorders

Conditions: Mood Disorders

Summary: the goal of this study is to examine the efficacy and safety of transcranial magnetic stimulation (tms) and deep tms (dtms) for treatment of different psychiatric and neurological disorders. subjects will be randomized into two groups: experimental (treated with pharmacotherapy and tms) and control group (treated only with pharmacotherapy). they and their clinicians will complete a battery of instruments that measure relevant symptoms, global functioning and quality of life. the first measurement will be done after the inclusion and before treatment. the second measurement will be made immediately after the end of treatment (after 4 weeks). the other measurements (follow-up) will be made after 3 and 6 months.


Eligibility criteria:
inclusion criteria: * diagnosed psychiatric or neurological disorder, duration of disorder for at least 5 years, inpatients or outpatients treated in psychiatric hospital sveti ivan exclusion criteria: * suicidality, psychosis, alcohol addiction, unable to complete the questionnaires
passion - p trial: ph adjusted sulfur-colloid, sentinel initiative on pain trial

Conditions: Breast Cancer

Summary: patients with breast cancer scheduled to undergo sentinel lymph node mapping and biopsy will be randomly assigned to one of four treatment groups: i: (standard of care at wramc): application of l-m-x topical anesthetic cream 4% to the breast within one hour of sub-areaolar injection of 4 ml 99mtc-sulfur colloid (1 mci in normal saline) ii. sub-areolar injection of 4 ml ph-adjusted 99mtc-sulfur colloid (1 mci in sodium bicarbonate) iii. sub-areolar injection of 4 ml ph-adjusted 99mtc-sulfur colloid (1 mci in 1% lidocaine) iv. sub-areolar injection of 4 ml ph-adjusted 99mtc-sulfur colloid (1 mci in sodium bicarbonate + 1% lidocaine) the primary study outcome is pain, which will be evaluated for each study group before, and after radiocolloid injection utilizing a standardized 10-point likert scale, the wong-baker faces pain rating scale, and the mcgill pain questionnaire. physician appraisal of patient pain (wong-baker faces pain rating scale) will be estimated during the radiocolloid injection and compared with that of the patient.

null hypothesis: there is no difference in overall pain intensity between standard and ph adjusted radiocolloid for patients undergoing sentinel lymph node mapping and biopsy for breast cancer. objectives and scientific aims: to compare the intensity of pain (wong-baker faces pain rating scale + mcgill pain questionnaire) associated with wramc's current standard and ph-adjusted radiocolloid for patients undergoing sentinel lymph node mapping and biopsy for breast cancer. to assess objectively physician appraisal of patient pain during the radiocolloid injection and compare physician interpreted pain score with patient reported pain score. define the success rate of intra-operative sln identification for each study group.

Eligibility criteria:
inclusion criteria: 1. female military healthcare beneficiaries should be over 18 years of age and capable of providing informed consent indicating awareness of the investigational nature of this trial, in keeping with institutional policy. 2. written informed consent must be obtained from each patient prior to entering the study. 3. female military healthcare beneficiaries with early breast cancer scheduled to undergo sentinel lymph node mapping and biopsy at wramc exclusion criteria: 1. female military healthcare beneficiaries with chronic pain syndrome (e.g. fibromyalgia) undergoing active narcotic-based treatment. 2. female military healthcare beneficiaries participating in other clinical trials the requirements of which may preclude complete involvement in this study. 3. female military healthcare beneficiaries with significant allergy to local anesthetics. 4. female military healthcare beneficiaries presenting with large (\>4cm), clinically node positive, painful, locally advanced breast cancer.

Keywords: breast cancer, sentinel lymph node mapping, biopsy